Palliative care doesn’t make death take a holiday, but it does make for a better end of life

That struggle has been a part of the human experience since the beginning, Ballantine said, highlighting portions from the Egyptian Book of the Dead and detailing the Celtic Christians who dealt with palliative care in the 6th century.

By ADAM GOLDSTEIN, Staff Writer, Updated: November 7, 2013 7:43 am

The spiritual stakes were high on a typical European deathbed in the 15th century.

Religious philosophy in the Western world had undergone a massive shift by the time the late Middle Ages rolled around. As the Black Plague ravaged the continent and claimed millions of lives, ideas about the ultimate fate of the human soul after death had turned downright melodramatic. Forces of good and evil were in an epic battle before a person drew their final breaths.

Jennifer Ballentine, executive director of the Life Quality Institute, detailed the “Ars Moriendi” during a lecture, Nov. 4 at the Fulginiti Pavillion on Anshutz Medical Campus. The Latin texts from the 15th century offered guidance on helping patients die properly according to Christian tradition.(Danielle Shriver/Aurora Sentinel)

“There wasn’t a grace period anymore,” Jennifer Ballantine said during a presentation at the Fulginiti Pavilion for Bioethics and Humanities on Nov. 4. “The demons were fighting for you and the angels were fighting for you on your deathbed.”

That’s where the “Ars Moriendi” came in, Ballantine explained. Ballantine is the executive director of the Colorado-based Life Quality Institute, a facility dedicated to end-of-life care and education. She detailed the “Ars Moriendi,” a pair of 15th-century texts that served as a guide for dealing with death and dying in one of the Western world’s darkest eras. The book, which was more popular than the Gutenberg Bible in the early eras of publishing, offered step-by-step instructions for preparing a patient for the afterlife.

“It coincided with the first of many plagues that spread across Europe,” Ballantine said. “It was a ‘Dummy’s Guide’ to blessed death.”

Ballantine spoke with a unique perspective as she delved into the art of palliative care in the Middle Ages. As the executive director of the Life Quality Institute, this former anthropologist and typesetter is now devoted to improving the state of palliative care in modern medicine. In an age and a society where death issues are often taboo, there are plenty of lessons to glean from this 600-year-old text, she said.

“We need to prepare for death throughout our lives,” Ballantine said, adding that even the non-religious can find something to relate to in this medieval Christian guidebook. “You will be finding your true self on that death bed and that’s all that will be there.”

That struggle has been a part of the human experience since the beginning, Ballantine said, highlighting portions from the Egyptian Book of the Dead and detailing the Celtic Christians who dealt with palliative care in the 6th century.

Published in two separate versions in 1415 and 1450, the “Ars Moriendi” offered a path for the final transition. It cataloged common “temptations” on a deathbed, traps like temptations, doubt, fear, desperation and preoccupation. It offered antidotes like faith, humility, acceptance and “truth telling.”

All of these guidelines came in a decidedly Christian context, but Ballantine insisted there are plenty of lessons for patients of all spiritual and religious backgrounds. The medieval text shows the value of simple steps like comfort, support and touch in guiding a loved one through the end of life. The approach feels timeless — it bears an uncanny similarity to the five stages of grief sketched out by Elisabeth Kubler-Ross in the 1960s, Ballantine said.

“People are accessing hospice care way too late,” she said. “We have a long way to go in making it available to the right people at the right time.”